AB1447 CATASTROPHISM IN MOROCCAN PATIENTS WITH CHRONIC RHEUMATIC DISEASES UNDER BIOLOGICS
Authors: H. Boutaibi, H. Azzouzi, I. Linda
Journal: Annals of the Rheumatic Diseases (2022)

Background Catastrophizing is a distortion of the perception of pain, both cognitively and emotionally, which leads patients to consider only the worst. There is a lack of knowledge about catastrophism in Moroccan patients with chronic rheumatic diseases under biologic DMARDs (disease-modifying anti-rheumatic drugs). Objectives To assess catastrophism and its associated factors in rheumatic patients under bDMARDs. Methods This is a cross-sectional study of patients admitted to a day hospital for biologic treatment evaluation. Patients included were all adults with SpA or RA diagnosed according to ASAS 2009 and ACR/EULAR 2010 classifications, respectively. The Pain Catastrophizing Scale (PCS) 1 was used to assess catastrophism. This scale is a self-report measure, consisting of 13 items scored from 0 to 4, resulting in a total possible score of 52. It is divided into three subscales: magnification, rumination and helplessness. A total score above 30 indicates a clinically relevant level of catastrophizing. Sociodemographic and treatment data were collected. Disease activity scores (DAS28, ASDAS) using C-reactive protein (CRP) dosage of the same day were calculated for each disease. Questionnaires were obtained for all patients for functional assessment (HAQ, BASFI), insomnia by the insomnia severity index (ISI), and depression by hospital anxiety and depression scale (HADS). Anxiety was evaluated by the generalized anxiety disorder-7 (GAD-7). Statistical analysis was done using regressions by SPSS.20. Results We included 75 patients with a mean age of 42.20 ± 16.206 years and a mean disease duration of 17.47 ± 8.758 years. Almost all patients (90.7%) had a disease lasting for more than 05 years. Twenty-nine patients (38.7%) had inactive disease. The average duration of bDMARDs use was 24.29 ± 18.96 months (27.83 ± 18.5 months in SpA patients and 19.53 ± 18.81 months in RA patients). Seventy-nine percent of these patients have received only one bDMARD, and 66.7% were currently taking a TNF inhibitor. The mean catastrophizing scores were 21.91 ± 11.38 for all patients, 22.05 ± 12.163 for SpA patients, and 21.72 ± 10.24 for RA patients. The prevalence of catastrophism was 25.3%, and the highest sub-score was helplessness (17.53 ± 3.95, p= 0). These scores were similar in RA and SpA patients. Catastrophizing was significantly associated with anxiety degree (p = 0.021, OR = 2.362, [1.211-4.607]), and swollen joints (p = 0.042, OR= 1.197, 95%IC [1.006-1.423]) using logistic regression analysis. Catastrophism scores were positively associated with the number of bDMARDs used (p = 0.044, ß = 0.233, 95%IC [0.095-7.211]). This association remained significant with anxiety (p&lt;0.0001) and the number of bDMARDs received (p=0.04) at multivariate regression adjusted on swollen joints, ISI and HADS. Conclusion Catastrophizing scores were high despite biotherapy use. They were related to anxiety disorder, swollen joints, and bDMARDs rotation. It would therefore be interesting to detect catastrophism in clinical routine to ensure good patients care. References [1]Sullivan M.J.L. et al. The Pain Catastrophizing Scale: Development and validation. Psychol. Assess. 1995, 7, 524–532. Disclosure of Interests None declared